Chemotherapy for Gallbladder Cancer

Because giving chemo into a vein (IV) isn't always helpful for gallbladder cancer, doctors have studied a different way to give it – right into the main artery going into the liver, called the hepatic artery. The hepatic artery also supplies most gallbladder tumors, so putting chemo into this artery means more chemo goes to the tumor. The healthy liver then removes most of the remaining drug before it can reach the rest of the body. This can lessen the chemo side effects. HAI may help some people whose cancer couldn’t be removed by surgery live longer, but more research is needed. This technique often requires surgery to put a catheter into the hepatic artery, and many people with gallbladder are not well enough to have this surgery.

Drugs used to treat gallbladder cancer

The chemo drugs most often used for gallbladder cancer include:

• Gemcitabine (Gemzar^®)
• Cisplatin (Platinol^®)
• 5-fluorouracil (5-FU)
• Capecitabine (Xeloda^®)
• Oxaliplatin (Eloxatin^®)

In some cases, 2 of these drugs are combined. For example, combining gemcitabine and cisplatin may help people live longer than getting just gemcitabine alone. When chemo is given with radiation, most often 5-FU or capecitabine is used.

Possible chemo side effects

Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow (where new blood cells are made), the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells can be affected by chemo, which can lead to side effects.

The side effects of chemo depend on the type and dose of drugs given and the length of time they are taken. Side effects can include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Increased chance of infections (from having too few white blood cells)
• Easy bruising or bleeding (from having too few blood platelets)
• Fatigue (from having too few red blood cells)

These side effects are usually short-term and go away after treatment ends. There are often ways to lessen these side effects or even prevent them. For example, drugs can be given to help prevent or reduce nausea and vomiting. Be sure to ask your doctor or nurse about medicines to help reduce side effects.

Along with the possible side effects above, some drugs can have their own specific side effects. For example, cisplatin and oxaliplatin can damage nerves (called neuropathy). This can cause numbness, tingling, weakness, and sensitivity to cold or heat, especially in the hands and feet. This goes away in most patients after treatment stops, but in some cases the effects can be long lasting.

Report any side effects you notice to your medical team so that they can be treated right away. Most side effects can be treated. In some cases, the doses of the chemo drugs may need to be reduced or treatment might need to be delayed or stopped to keep the effects from getting worse.